Colon Surgery

Anatomy and colon surgery

The colon, or large intestine, is the final portion of the digestive tract that stores and eliminates stool. In a healthy colon, waste moves smoothly within the tube-like organ. However, the tissue that comprises the colon can change, causing growths, either cancerous or benign, to form along the colon wall.

Polyps

A polyp is a benign, or non-cancerous, growth that occurs on the colon's inner lining, and can range from the size of a pea to as large as a golf ball. The larger the polyp grows, the more likely it is that it will become cancerous. Having polyps removed as soon as possible through colon surgery will help prevent them from becoming cancerous.

Colon cancer

Cancer on the colon wall is comprised of abnormal cells that are growing at an uncontrolled rate. Generally the size of a mushroom or larger, colon cancer can continue to grow and spread to other parts of the body, such as the lymph glands, liver, and lungs. Cancers should be removed through surgery as soon as possible to prevent them from spreading, or metastasizing.

About the colon

Your body has approximately 20 feet of small intestine plus five feet of large intestine. Even if part of your intestine is removed through colon surgery, enough remains to allow you to have a normal lifestyle and digestive function.

Symptoms and diagnosis

If your physician determines through your medical and family history that you are at risk for colon cancer or polyps, he or she will conduct a comprehensive exam to check for abnormalities.

Your doctor may perform:

a digital rectal exam, during which he or she uses a gloved finger to check for tissue changes in the rectum

a sigmoidoscopy, wherein a lighted tube is inserted into the colon to remove tissue samples

a barium enema, which retrieves an image of the entire colon by filling the colon with liquid barium and taking x-rays

These tests can be used individually or in combination to pinpoint which areas are in need of treatment.

Colon surgery procedure

In some cases, a colonoscopy can be used to view the entire colon and remove small polyps. Polyps can also be removed with surgery through the anus, or, in rare cases, through abdominal surgery.

To treat colon cancer, surgical removal of the affected portion of the colon is necessary. After the growth and surrounding portion of the colon are removed, the colon is reconnected and normal bowel function restored. Prior to surgery, your physician will want to check if the cancer has spread to other parts of the body. Radiation therapy may also be necessary before or after surgery.

Colon surgery is performed under general anesthesia so you are asleep during the surgery and unable to feel any discomfort or pain.

Preparing for colon surgery

Prior to surgery you should review any prescriptions you take with your doctor, since some may may need to be discontinued a week or days before your colon surgery, such as drugs that interfere with blood clotting including aspirin.

You usually are admitted to the hospital one day prior to surgery.

Eight hours before surgery you won't drink or eat anything, including water.

The night before your surgery, an enema or laxatives cleans your bowel.

Blood tests, an EKG to check your heart, and chest x-rays may be performed.

After colon surgery

Without complications, most patients can expect to stay in the hospital for four to eight days following colon surgery.

For a few days, a nasogastric (NG) tube will run from your nose to your stomach to make sure that your stomach stays empty. You will be fed intravenously during this time.

You will soon begin a clear liquid diet and, after that, a diet of soft, low-fiber foods until healing is complete.

You will receive training on how to properly care for your stoma, which is the surgically-created opening that allows for the removal of feces. A stoma therapist will instruct you on how to change your colostomy bag or how to irrigate the stoma so that a bag may not be necessary.

You should begin to feel normal again after about six weeks, but should avoid heavy lifting and strenuous exercise. You may still tire easily for several months, and should be sure to rest whenever you feel fatigued.

You may be able to resume normal activities after two months, but should expect to take time off from work for one to three months.

Be sure to see your doctor regularly and follow a high-fiber, low-fat diet as you resume your daily lifestyle.

Inflammatory bowel disease

Inflammatory Bowel Disease (IBD) encompasses a group of diseases that cause the intestines to become red and swollen, or inflamed. The two primary types of IBD are Crohn's disease and ulcerative colitis. With Crohn's disease, painful ulcers form along the intestinal tract. With ulcerative colitis, ulcers form in the lower part of the large intestine and the rectum. Both conditions can be quite painful and can sometimes lead to life-threatening complications if left untreated. Symptoms of IBD include diarrhea, abdominal pain and cramping, bloody stool, rapid or unexplained weight loss, fever, and general fatigue.

Inflammatory Bowel Disease can be treated with anti-inflammatory drugs, immune system suppressors, and other medications to reduce pain and symptoms, as well as lifestyle changes. If medication and lifestyle changes are not successful, surgery may be necessary to remove the damaged portion of the digestive tract, scar tissue, or fistulas, which are abnormal passageways that form between organs (more common with Crohn's disease).

Diverticulosis and diverticulitis

Diverticulosis is a common condition in older patients, especially those over 60. Without adequate fiber and water intake, a patient's stool can become hard and more difficult to move through the colon. As the muscles work harder, the extra pressure causes the colon wall to bulge out and form pouches, called diverticula. These pouches are generally asymptomatic, but can result in cramping, bloating, constipation, diarrhea, or rectal bleeding. Diverticulosis can usually be treated through a high-fiber, high-liquid diet. In serious cases, stool softeners and antispasmodic medications may be necessary.

If the diverticula become infected or inflamed, they can swell or rupture. This condition is called diverticulitis, and may cause pain, fever, chills, cramping, bloating, constipation, or diarrhea. In mild cases, diverticulitis can be treated with antibiotics, rest, and dietary changes. However, if the condition is serious, surgery may be necessary to remove the affected area of the colon.